眶颅底异物伤的经鼻内镜手术治疗  

Transnasal endoscopic management of foreign body injuries at orbital-skull base

作　　者：康军[1] 傅继弟[1] 周军[2] 刘浩成[1] 董浩[1] 孙思[1] 杨澎[1] 吴江平[1] 邱锷[1] 宋维贤[2] 

机构地区：[1]首都医科大学附属北京同仁医院神经外科,100730 [2]首都医科大学附属北京同仁医院眼外伤科,100730

出　　处：《中华医学杂志》2014年第31期2438-2440,共3页National Medical Journal of China

摘　　要：目的：探讨内镜下经鼻颅底入路取出眶颅底区异物的可行性和方法。方法回顾性分析北京同仁医院神经外科2009年1月至2014年1月8例眶颅底区异物伤的病例。其中金属异物4例，植物性异物4例。位于眼眶内6例，鼻眶沟通性异物2例，术前视力丧失6例，视力下降2例，眼球活动障碍5例。全部病例采用内镜下经鼻入路进入眼眶内或眶颅底区取出异物。结果8例异物均完整取出，随访3个月至4年，术前视力丧失病例术后视力无恢复，视力下降2例病人术后3个月均恢复正常视力。眼球活动障碍完全恢复4例，部分恢复1例。结论眶颅底区异物伤病例可根据异物位置选择经鼻内镜取出异物，具有微创，无手术瘢痕的优点。Objective To explore the feasibility and methods of transnasal endoscope for removing foreign bodies at orbital-skull base.Methods Retrospective analyses were performed for 8 cases of foreign body injuries at orbital-skull base at our department from January 2009 to January 2014.The foreign bodies were metallic （n=4） and wooden （n=4）.Six cases were only within orbit while the remainder had nasal-orbital foreign bodies.The symptoms included preoperative visual loss （n=6）, visual deterioration （n=2） and eye movement disorder （n=5）.All underwent transnasal endoscopic removal.Results Foreign bodies were totally removed.During a follow-up period of 3 months to 4 years, there was no recovery of preoperative visual loss （ n=6 ）.Two patients with reduced vision recovered to normal after 3 months.Eye movement disorder fully recovered in 4 cases and 1 case of eye movement disorder had partial recovery.Conclusion Endoscopic removal of foreign body at orbital-skull base has the advantage of mini-invasiveness and non-facial surgical scar.

关 键 词：内镜 颅底外科 异物伤 

分 类 号：R651.1[医药卫生—外科学]